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1.
BMJ Open Qual ; 10(2)2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33820758

RESUMEN

BACKGROUND: Mealtimes occur six times a day on eating disorder (ED) inpatient units and are a mainstay of treatment for EDs. However, these are often distressing and anxiety provoking times for patients and staff. A product of patients' distress is an increase in ED behaviours specific to mealtimes. The aim of this quality improvement project was to decrease the number of ED behaviours at mealtimes in the dining room through the implementation of initiatives identified through diagnostic work. METHODS: The Model for Improvement was used as the systematic approach for this project. Baseline assessment included observations in the dining room, gathering of qualitative feedback from staff and patients and the development of an ED behaviours form used by patients and staff. The first change idea of a host role in the dining room was introduced, and the impact was assessed. RESULTS: The introduction of the host role has reduced the average number of ED behaviours per patient in the dining room by 35%. Postintervention feedback demonstrated that the introduction of the host role tackled the disorganisation and chaotic feeling in the dining room which in turn has reduced distress and anxiety for patients and staff. CONCLUSIONS: This paper shows the realities of a quality improvement (QI) project on an ED inpatient unit during the COVID-19 pandemic. The results are positive for changes made; however, a large challenge, as described has been staff engagement.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Servicio de Alimentación en Hospital/normas , Comidas/psicología , Mejoramiento de la Calidad , Adulto , Ansiedad/psicología , Técnicas de Observación Conductual , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Femenino , Humanos , Pacientes Internos/psicología , Masculino , Personal de Hospital/psicología , Investigación Cualitativa , Estrés Psicológico/psicología
2.
J Psychiatr Pract ; 27(2): 137-144, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33656821

RESUMEN

The widespread prevalence of coronavirus disease 2019 (COVID-19) means that inpatient psychiatric units will necessarily manage patients who have COVID-19 that is comorbid with acute psychiatric symptoms. We report a case of recurrence of respiratory symptoms and positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) testing in a patient on an inpatient psychiatric unit occurring 42 days after the initial positive SARS-CoV-2 RT-PCR test, 38 days after initial symptom resolution, and 30 days after the first of 3 negative SARS-CoV-2 RT-PCR tests. Over the course of the admission, the patient was safely initiated on clozapine. Recent literature on COVID-19's potential recurrence and neuropsychiatric effects is reviewed and implications for the management of COVID-19 on inpatient psychiatric units are discussed. In the era of COVID-19 and our still-developing understanding of this illness, psychiatrists' role as advocates and collaborators in our patients' physical health care has become even more critical.


Asunto(s)
Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico , Trastorno Depresivo Mayor/complicaciones , Trastorno Depresivo Mayor/tratamiento farmacológico , Trastornos Psicóticos/complicaciones , Trastornos Psicóticos/tratamiento farmacológico , Adulto , Alcoholismo/complicaciones , Alcoholismo/diagnóstico , /psicología , Clozapina , Trastorno Depresivo Mayor/diagnóstico , Hospitales Psiquiátricos , Humanos , Pacientes Internos/psicología , Masculino , Mirtazapina/uso terapéutico , Trastornos Psicóticos/diagnóstico , Recurrencia , Sertralina/uso terapéutico , Intento de Suicidio
5.
Psychiatry Res ; 298: 113779, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33561619

RESUMEN

This current cross sectional survey was carried out amongst patients and staff in an acute psychiatric inpatient unit in the very first weeks of the ongoing pandemic outbreak of COVID-19 in Norway. Most patients found the visiting restrictions difficult, many reported that the pandemic made them feel unsafe, affected their sleep and that they feared transmission from other patients. Among staff, almost half were afraid that they would contract the virus, a majority feared they would bring the virus home and infect their family and one third were concerned that the pandemic compromised the treatment provided for the patients.


Asunto(s)
Actitud del Personal de Salud , Conocimientos, Actitudes y Práctica en Salud , Pacientes Internos/psicología , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Personal de Hospital/psicología , Servicio de Psiquiatría en Hospital , Enfermedad Aguda , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Noruega
6.
J Psychosom Res ; 143: 110399, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33618149

RESUMEN

OBJECTIVES: Little is known about the mental health outcomes of hospitalized COVID-19 patients. The aims of the study were: (1) to examine the trajectories of anxiety, depression, and pandemic-related stress factors (PRSF) of COVID-19 hospitalized patients one-month following hospitalization; (2) to assess the presence of post-traumatic stress symptoms (PTSS) a month after hospitalization; (3) to identify baseline risk and protective factors that would predict PTSS one month after hospitalization. METHODS: We contacted hospitalized COVID-19 patients (n = 64) by phone, at three time-points: during the first days after admission to the hospital (T1); after ~two weeks from the beginning of hospitalization (T2), and one month after hospitalization (T3). At all time-points we assessed the levels of anxiety and depression symptoms, as well as PRSF. At T3, PTSS were assessed. RESULTS: The levels of depressive and anxiety symptoms decreased one-month following hospitalization. Moreover, higher levels of anxiety (standardized ß = 1.15, 95% CI = 0.81-1.49, p < 0.001) and depression (ß = 0.97, 95% CI = 0.63-1.31 p < 0.001) symptoms during the first week of hospitalization, feeling socially disconnected (ß = 0.59, 95% CI = 0.37-0.81 p < 0.001) and experiencing a longer hospitalization period (ß = 0.25, 95% CI = 0.03-0.47 p = 0.026) predicted higher PTSS scores a month post-hospitalization. CONCLUSIONS: We identified early hospitalization risk factors for the development of PTSS one month after hospitalization that should be targeted to reduce the risk for PTSS.


Asunto(s)
Ansiedad/psicología , Depresión/psicología , Hospitalización , Pacientes Internos/psicología , Trastornos por Estrés Postraumático/psicología , Adulto , Ansiedad/complicaciones , Depresión/complicaciones , Femenino , Estudios de Seguimiento , Humanos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Factores de Riesgo , Trastornos por Estrés Postraumático/complicaciones , Evaluación de Síntomas
7.
Z Psychosom Med Psychother ; 67(1): 70-77, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33565372

RESUMEN

Objectives: This study aimed to investigate the effect of waiting for inpatient psychosomatic psychotherapy and the prediction of treatment outcome from the effect of waiting in depressed patients. Methods: A total of N = 519 patients were assessed for depressive symptoms before their initial intake interview, at the time of their hospital admission (on average 6 weeks after the intake), and at discharge (after eight weeks of inpatient psychotherapy). Results: There was a small to moderate reduction in depressive symptoms from intake interview to hospital admission. This effect was independent from the waiting duration. Latent change from intake interview to hospital admission was a significant moderate predictor of treatment outcome at discharge. Conclusions: Findings imply that the prospect of inpatient psychotherapy may affect patients' depression severity. Furthermore, patients who benefit more from the prospect of treatment may also achieve higher therapeutic effects.


Asunto(s)
Depresión/psicología , Depresión/terapia , Pacientes Internos , Psicoterapia , Humanos , Pacientes Internos/psicología , Trastornos Psicofisiológicos/psicología , Trastornos Psicofisiológicos/terapia , Resultado del Tratamiento
8.
Z Psychosom Med Psychother ; 67(1): 56-69, 2021.
Artículo en Alemán | MEDLINE | ID: mdl-33565379

RESUMEN

Psychometric evaluation of the Experiences in Close Relationships Revised German 12-item version (ECR-RD 12) in a sample of psychotherapeutic inpatients Objectives: The ECR-R assesses the self-description of adult attachment strategies in romantic relationships. The present study evaluates the psychometric properties of the German 12-item short version ECR-RD 12 in a large sample of patients in psychotherapeutic inpatient treatment. Method: Inpatients in psychotherapeutic treatment (N = 2231) were assessed using the ECR-RD 12 and other clinical questionnaires. Its psychometric properties and factor structure of were evaluated. Results: The psychometric properties of the short form measure were in line with the German full length version (ECR-RD). In contrast to theoretical assumptions, factor analysis suggested a three factor solution in the present sample. Discussion: The ECR-RD 12 can be recommended as a screening measure for assessing attachment styles in inpatient psychotherapeutic settings. Further studies are required to investigate the factor structure of the measure in clinical samples.


Asunto(s)
Pacientes Internos/psicología , Relaciones Interpersonales , Psicometría , Parejas Sexuales/psicología , Traducción , Adulto , Análisis Factorial , Femenino , Alemania , Humanos , Masculino , Apego a Objetos , Encuestas y Cuestionarios
9.
Prax Kinderpsychol Kinderpsychiatr ; 70(2): 134-153, 2021 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-33565952

RESUMEN

The Role of Partnership Status and Relationship Satisfaction in Inpatient Mother-Child Treatment in Postpartum Mental Disorders The study examines the partnership status and satisfaction in connection with symptoms of postpartum mental disorders, mother-child attachment and outcome of inpatient mother-child treatment. Two sub-studies were carried out. In the first study, N = 126 mothers with postpartum mental disorders who went to a preliminary consultation for inpatient mother-child treatment stated their symptom burden (SCL-90), mother-child attachment (PBQ) and satisfaction with their partner relationship (PFB-K). Mothers with stressed relationships showed the highest level of symptom burden and impaired attachment. Mothers without a partner reported the least amount of impairment in mother-child attachment. In the second study, N = 41 mothers were examined over the course of inpatient treatment (within-subject design with a waiting-list). The initial relationship satisfaction was not predictive of symptom reduction or improvement in mother-child attachment. An increase in satisfaction during the treatment was though correlated with an improvement in mother-child attachment.


Asunto(s)
Pacientes Internos/psicología , Relaciones Madre-Hijo/psicología , Madres/psicología , Apego a Objetos , Satisfacción Personal , Periodo Posparto/psicología , Parejas Sexuales/psicología , Depresión Posparto/psicología , Femenino , Humanos , Lactante , Recién Nacido , Estado Civil/estadística & datos numéricos
12.
J Affect Disord ; 278: 15-22, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-32949869

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) continues to spread across the globe, but patient experiences are rarely documented. OBJECTIVE: To explore the psychology of COVID-19 patients during hospitalization. METHODS: A phenomenological and robust sampling approach was employed. Sixteen patients admitted to the First Affiliated Hospital of Henan University of Science and Technology with COVID-19 from 20th January to 1st March 2020 were selected. Data were collected through semi-structured interviews, phone calls, or face-to-face interviews using quarantine measures. Data were analyzed using the Colaizzi method. RESULTS: The psychological experience of COVID-19 patients during hospitalization could be summarized into five themes. Firstly, attitudes toward the disease included fear, denial, and stigma during the early stages, which gradually developed into acceptance in the later stages. Secondly, the major source of stress included the viral nature of the disease, quarantine measures, and concerns regarding the health of family members. Thirdly, reactions of body and mind included disease stage-dependent emotional responses, excessive attention to symptoms, rumination, and changes in diet, sleep, and behavior. Fourthly, supportive factors included psychological adjustments, medical care, and family and social support. Finally, the disease resulted in psychological growth and patients viewed problems with gratitude through the cherishing of life, family, bravery, and tenacity. CONCLUSION: COVID-19 patients gradually changed their attitude toward the disease and displayed emotional responses dependent on the stage of the disease. Negative emotions dominated during the early stages but gradually gave way to mixed positive and negative emotions. Active guidance of psychological growth may therefore promote physical and mental recovery in COVID-19 patients.


Asunto(s)
Actitud Frente a la Salud , Hospitalización , Pacientes Internos/psicología , Adaptación Psicológica , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Investigación Cualitativa , Adulto Joven
14.
PLoS One ; 15(10): e0239815, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33064721

RESUMEN

INTRODUCTION: There is a dearth of research to guide acute adolescent mental health inpatient care. Self-determination Theory provides evidence that meeting needs for relatedness, autonomy and competence is likely to increase wellbeing and intrinsic motivation. These needs may be able to be met in the inpatient environment. METHOD: This qualitative study aimed to explore young people's experience of acute mental health inpatient care with particular attention to meeting of these three needs. Fifteen young people were interviewed. The importance of relatedness with staff, other young people and families was identified. RESULTS: Relatedness with staff and peers were valued parts of admission. Some young people describe enhanced relatedness with family. They described loss of autonomy as a negative experience but appreciated opportunities to be involved in choices around their care and having more freedom. Coming into hospital was associated with loss of competence but they described building competence during the admission. Engaging in activities was experienced positively and appeared to enhance meeting of all three needs. Meeting of the three needs was associated with an experience of increased safety. CONCLUSIONS: Engaging young people in activities with a focus on relatedness, autonomy and competence may have specific therapeutic potential. Autonomy, experience of competence and connection with staff may enhance safety more effectively than physical containment. Peer contact may have untapped therapeutic value we understand little of. This study supports the value of Self-determination Theory as a guide day to day inpatient care to meet the needs of adolescents for relatedness, autonomy and competence.


Asunto(s)
Salud del Adolescente , Salud del Niño , Pacientes Internos/psicología , Salud Mental , Autonomía Personal , Teoría Psicológica , Adolescente , Niño , Hospitalización , Humanos , Grupo Paritario , Investigación Cualitativa , Encuestas y Cuestionarios , Adulto Joven
15.
Transl Psychiatry ; 10(1): 355, 2020 10 19.
Artículo en Inglés | MEDLINE | ID: mdl-33077738

RESUMEN

This study examined the neuropsychiatric sequelae of acutely ill patients with coronavirus disease 2019 (COVID-19) infection who received treatment in hospital isolation wards during the COVID-19 pandemic. Ten COVID-19 patients who received treatment in various hospitals in Chongqing, China; 10 age- and gender-matched psychiatric patients; and 10 healthy control participants residing in the same city were recruited. All participants completed a survey that collected information on demographic data, physical symptoms in the past 14 days and psychological parameters. Face-to-face interviews with COVID-19 patients were also performed using semi-structured questions. Among the COVID-19 patients, 40% had abnormal findings on the chest computed topography scan, 20% had dysosmia, 10% had dysgeusia, and 80% had repeated positivity on COVID-19 reverse-transcription polymerase chain reaction testing. COVID-19 and psychiatric patients were significantly more worried about their health than healthy controls (p = 0.019). A greater proportion of COVID-19 patients experienced impulsivity (p = 0.016) and insomnia (p = 0.039) than psychiatric patients and healthy controls. COVID-19 patients reported a higher psychological impact of the outbreak than psychiatric patients and healthy controls, with half of them having clinically significant symptoms of posttraumatic stress disorder. COVID-19 and psychiatric patients had higher levels of depression, anxiety and stress than healthy controls. Three themes emerged from the interviews with COVID-19 patients: (i) The emotions experienced by patients after COVID-19 infection (i.e., shock, fear, despair, hope, and boredom); (ii) the external factors that affected patients' mood (i.e., discrimination, medical expenses, care by healthcare workers); and (iii) coping and self-help behavior (i.e., distraction, problem-solving and online support). The future direction in COVID-19 management involves the development of a holistic inpatient service to promote immune and psychological resilience.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/psicología , Pacientes Internos/psicología , Neumonía Viral/psicología , Cuarentena/psicología , Enfermedad Aguda , Adulto , China , Estudios de Evaluación como Asunto , Femenino , Humanos , Pacientes Internos/estadística & datos numéricos , Masculino , Pandemias , Cuarentena/métodos , Cuarentena/estadística & datos numéricos
17.
Clin Neuropsychol ; 34(7-8): 1395-1410, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32912043

RESUMEN

Objective: The COVID-19 pandemic is a global health crisis that has created sudden and unique challenges within the field of clinical neuropsychology. Adapting neuropsychology services using teleneuropsychology models (e.g. video or telephone assessments) may not always be a viable option for all providers and settings. Based on the existing teleneuropsychology literature, we propose a "contactless" evidence-based inpatient test battery to be used for in-person assessments amenable to physical distancing. Method: In addition to the proposed test battery, we suggest a decision-making workflow process to help readers determine the appropriateness of the proposed methods given their patients' needs. Considerations for special populations (i.e. seniors, patients with brain injury, psychiatric patients), feedback, limitations of the proposed physical distancing approach, and future directions are also discussed. Conclusions: Our aim is that the suggested teleneuropsychology-informed battery and model may inform safe and practical neuropsychological inpatient assessments during the COVID-19 pandemic and other situations requiring contact precautions for infection prevention and control.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/terapia , Prestación de Atención de Salud/tendencias , Pruebas Neuropsicológicas , Neuropsicología/tendencias , Neumonía Viral/terapia , Tacto , Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud/métodos , Humanos , Pacientes Internos/psicología , Neuropsicología/métodos , Pandemias , Neumonía Viral/epidemiología
19.
PLoS One ; 15(9): e0239306, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32946537

RESUMEN

Patient satisfaction, a healthcare recipient's reaction to salient aspects of their service experience, has been considered an important metric of the overall quality of healthcare in both advanced and developing countries. Given the growing number of studies on patient satisfaction in developing and transitioning countries, publications using high-quality patient surveys in these countries remain scarce. This study examines factors associated with inpatient satisfaction levels using nationwide, large-scale interview data from 10,143 randomized and voluntary patients of 69 large and public hospitals in Vietnam during 2017-2018. We find that older patients, poor patients, female patients, patients with lower levels of education, patients not working for private enterprises (or foreign enterprises), and rural patients reported higher levels of overall satisfaction. Health insurance is found to have positive influence on overall patient satisfaction, primarily driven by limiting patient concerns about treatment costs, as well as increasing positive perceptions of hospital staff. We further find that patients who paid extra fees for their hospital admission expressed higher scores for hospital living arrangements and medical staff, but were mostly dissatisfied with treatment costs. These findings have important policy implications for current policy makers in Vietnam as well as for other countries with limited healthcare resources and ongoing healthcare reforms.


Asunto(s)
Reforma de la Atención de Salud/tendencias , Satisfacción del Paciente , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Costos de la Atención en Salud/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Hospitales Públicos/economía , Humanos , Pacientes Internos/psicología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Servicios de Salud Rural , Vietnam/epidemiología , Adulto Joven
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